Current data for total mortality from violence, malnutrition, and disease
Eric Reeves | August 31, 2005
Building on fourteen previous assessments of mortality in Darfur, the present analysis argues that conflict-related deaths since the outbreak of major hostilities in February 2003—from all causes—now exceed 370,000 (see APPENDIX 1 for data and statistical analysis). This total represents an increase of more than 10,000 from the last assessment (June 30, 2005 at http://www.sudanreeves.org/modules.php?op=modload&name=Sections&file=index&req=viewarticle&artid=515&page=1). These “excess deaths” (in the euphemizing phrase of epidemiologists) continue to occur chiefly because of previous and continuing genocidal efforts by Khartoum’s National Islamic Front (NIF), “deliberately inflicting on the [non-Arab or African population] groups [of Darfur] conditions of life calculated to bring about [their] physical destruction in whole or in part” (Article 2, clause [c] of the 1948 UN Convention on the Prevention and Punishment of the Crime of Genocide).
Genocide by attrition has grimly settled in for the foreseeable future, though there is scant new data that allows for a more accurate statistical analysis of its human consequences. Nor is there reason to believe that further epidemiological data will be assembled in the near term by the UN (the NIF made the last UN mortality study extremely precarious, even dangerous), or that humanitarian organizations will be able to overcome their fear of losing access to Darfur by publishing mortality data. Far too much of the effort in quantifying genocide in Darfur remains inferential, even as the human toll grows relentlessly.
GENOCIDE AND THE NEW “GOVERNMENT OF NATIONAL UNITY”
Disturbingly, some have concluded that the NIF will be less able to “deliberately inflict” conditions of genocide in Darfur with the impending formation of a “Government of National Unity” (GNU). The reasoning is that somehow the very presence of the Sudan People’s Liberation Movement (SPLM) in this new government will by itself reconstitute the brutal calculus of genocidal destruction that presently defines NIF policy in Darfur, and that mortality rates will decline accordingly.
This is simply not true.
Indeed, it was not true in any significant sense even when John Garang led the SPLM, with his extensive regional and international contacts (including with the leadership of the Darfur insurgency movements). But the ability of the SPLM to change Khartoum’s Darfur policy diminished substantially with the death of Garang, and his replacement by Salva Kiir as First Vice-President in the new GNU: the NIF do not regard Kiir as having either sufficient international stature or political throw-weight in the north to bring about policy changes. Moreover, even with all necessary convictions about Darfur, Kiir remains overwhelmed by the difficult and increasingly urgent concerns of southern governance (e.g., forming a Government of South Sudan; ensuring that Khartoum’s troops deploy on schedule from Juba—a growing concern; dealing with threatening militia deployments in the oil regions; assisting desperately needy civilians in Bahr el-Ghazal and Western Upper Nile; providing resources for the hundreds of thousands of returning southerners).
To be sure, Kiir has dutifully promised an imminent SPLM “briefing” of the NIF on its views of Darfur (Salva Kiir, interview in Al-Ahram newspaper [Cairo; dateline: Khartoum], August 28, 2005). But it is simply disingenuous of the international community to see in this any development of real significance. The NIF will simply dismiss, without consequence, SPLM views on “northern matters.”
Because the inclusion of the SPLM in the new Government of National Unity cannot by itself change the dynamic of ethnically-targeted human destruction in Darfur, genocide will continue until forcefully halted by the international community. But there are no signs that the political will exists to undertake this most urgent task. As a consequence, in addition to the epidemic of rape and sexual violence in Darfur, violent deaths also continue to be part of the genocidal destruction. And these deaths are certainly well in excess of the “100 per month” that the African Union and UN political leadership disingenuously offer as a representative figure (AU reporting on, let alone investigation of, violent mortality is far too limited and erratic to yield meaningful data).
THE ENGINE OF GENOCIDAL DESTRUCTION IN DARFUR
Still, there can be no denying that the primary causes of death now are not violent assaults but rather malnutrition and disease; given the limitations to humanitarian assistance and the impending failure of the fall 2005 harvest, these deaths will continue to mount at an unconscionable rate for the foreseeable future. Substantial gaps in the provision of medicine, medical care, shelter, sanitary facilities, and especially clean water all pose especially great health threats in the midst of the current rainy season.
Shortfalls in humanitarian capacity are due not only to the rains but also to shameful funding shortfalls by wealthy nations, as well as inadequate planning. Acute logistical and transport difficulties, lack of fuel (representing inadequate anticipation of the consequences of Khartoum’s annual shutdown of the country’s main refinery for maintenance), and inadequate resources to keep pace with the water and sanitary needs of well over 2 million people in and around camps for displaced persons—these are only some of the challenges facing humanitarian workers in Darfur, despite their heroic efforts.
Still looming as the greatest obstacle to humanitarian relief for more than 3.5 million conflict-affected people throughout Darfur is insecurity—insecurity deliberately sustained by the NIF through the ongoing use of its militia proxies, the Janjaweed. “Banditry,” an increasingly convenient catch-all term for opportunistic violence by many parties—including former armed elements of both the Janjaweed and the insurgencies—is clearly on the rise. But there is far too little said about how previously orchestrated violence by NIF regular armed forces and the Janjaweed have created a “climate of impunity” not only for themselves, but for all who wield a gun. Certainly evidence from the ground in Darfur makes clear that until security improves dramatically, food production in Darfur will remain at a virtual standstill, and the people of Darfur will remain dependent upon international food relief that is increasingly at risk during transport from all forms of violent attack.
GROWING OBSTRUCTION OF HUMANITARIAN RELIEF PORTENDS GREATER MORTALITY
This growing dependence upon international relief, including food and critical non-food items (medicine, shelter, water purification), is the context in which to understand the NIF’s ongoing obstruction and denial of humanitarian aid efforts (see “Genocidal Choke-hold in Darfur: Khartoum’s continuing restriction of humanitarian aid,” at: http://www.sudanreeves.org/modules.php?op=modload&name=News&file=article&sid=65&mode=thread&order=0&thold=0).
Moreover, Khartoum’s efforts of obstruction may have entered a new and yet more dangerous phase. Though not yet widely reported, new visa requirements for entry into Sudan have been put in place by the NIF—immediately prior to the official formation of the GNU and without consulting the SPLM leadership. The new visa policy requires any non-Sudanese entering any part of Sudan—north or south—to secure a visa from Khartoum. Whereas previously humanitarian workers and others in SPLM-controlled parts of southern Sudan required only a pass from the humanitarian wing of the SPLM, they now will require a visa from the NIF-controlled bureaucracy in Khartoum.
In assessing the performance of the NIF in responding to humanitarian travel and access needs, we should recall the observations made by UN officials as part of the Annex to Kofi Annan’s July 2005 report to the UN Security Council:
“the humanitarian community continues to face numerous obstacles in discharging their duties, including difficulties for international nongovernmental organizations to obtain visas for new staff (particularly of African nationalities) as well as multi-entry visas; the length of time in processing visas; inconsistency in applying/interpreting procedures.” (Annex, paragraph 7, July 2005 monthly report of the Secretary-General to the Security Council concerning Darfur)
Even deployment of the UN peace support operation for southern Sudan, scandalously and dangerously behind schedule, has faced significant visa obstructions. For example:
“Visa problems are contributing to delays in deploying thousands of UN peacekeepers in southern Sudan, the German Foreign Ministry said Monday [August 8, 2005].” (Associated Press, August 8, 2005)
This newly imposed blanket visa requirement will have severe and highly unfortunate consequences for humanitarian organizations operating in southern Sudan, where human needs are in many areas as desperate as those in Darfur. Organizations operating out of Kenya, and to a lesser extent Uganda, will face a new and potentially disastrous obstacle. Moreover, the US embassy in Khartoum will no longer grant “country clearance” to US government employees seeking access to Sudan: these employees will also require a Khartoum-granted visa. Thus all US field workers for Sudan will be controlled out of Khartoum, with delays and obstruction inevitable. It is no accident that this requirement was promulgated unilaterally by the NIF shortly before the SPLM joined the Government of National Unity (GNU).
This new visa requirement takes on especially ominous meaning in light of a recent announcement made through the NIF-controlled press in Khartoum. The UN Daily Press Review for Sudan (August 22, 2005) includes a dispatch from the Khartoum newspaper Al-Sahafa that reflects new NIF policies with respect to humanitarian organizations. The headline to the dispatch could not be more threatening in reporting on NIF policy, again promulgated prior to the actual inauguration of the GNU and without consulting the SPLM officials who will nominally soon be part of the GNU:
“Government gives humanitarian agencies 3 months to put right their legal status.”
Here we must recall the extreme difficulties the NIF has created for humanitarian organizations since the beginning of the Darfur crisis. As long ago as December 2003 the evidence of deliberate obstruction was unambiguous. Tom Vraalsen, the UN Secretary-General’s Special Envoy for Humanitarian Affairs in Sudan, declared at the time that Khartoum was “systematically” (Vraalsen’s word choice) denying humanitarian relief to the African tribal populations of Darfur, and that Khartoum’s actions had brought “present humanitarian operations practically to a standstill” (Tom Vraalsen, Note to the UN Emergency Relief Coordinator for Sudan, December 8, 2003).
Countless instances of obstruction, delay, harassment, arrest, and violent assault have subsequently been reported by humanitarian organizations as occurring on a systematic basis. Several months ago Human Rights Watch provided an updated overview that remains fully accurate at present:
“The UN has estimated that as many as 3.5 to 4 million people in Darfur will not have enough to eat in the next few months. The Sudanese government has recently stepped up its bureaucratic war on the vast humanitarian relief effort that is attempting to help millions of Darfurians. Since December , the Sudanese government has been trying to intimidate some humanitarian agencies in Darfur through arbitrary arrests, detentions and other more subtle forms of harassment.” (Human Rights Watch press release, May 24, 2005)
These are not accidental difficulties, or simple bureaucratic inefficiency: this is an extremely well-orchestrated, relentless war of attrition against the efforts of humanitarian organizations to respond to genocidal destruction. The consequences of these obstructionist policies can be measured in tens of thousands of human lives lost and untold suffering.
Nor can we forget the violent intimidation the NIF has also orchestrated against aid workers (particularly Sudanese nationals), or the arrest earlier this summer of the two senior officials of the distinguished Doctors Without Borders/Medecins Sans Frontieres (MSF)-Holland, this because of MSF’s courage in publishing a scathing indictment of rape as a weapon of war in Khartoum’s assault on the people of Darfur. All this continues, modulated and adapted only to escape the most direct international censure.
Thus we must attend carefully to the implications of the Al-Sahafa report, and what it threatens in the way of new abilities to obstruct humanitarian access (and ultimately how this obstruction threatens civilian lives in Darfur):
“The government has given the humanitarian organisations working in the Sudan a period of three months to readjusting their legal status to the new Voluntary Work Act of 2005, which was endorsed by the President of the Republic, Omer Al-Bashir last week.” [What stands as essentially an executive decree was issued without consulting the SPLM, even as it represents a policy that that runs directly counter to the interests of the people of South Sudan and Darfur—ER.]
“The new law entrusts the Registrar of Organisations at the Ministry of Humanitarian Affairs with the responsibility of registration of the humanitarian agencies. According to the Minister of Humanitarian Affairs, Ibrahim Mahmood Hamid, the aim of the new move is to regulate and improve the work of the humanitarian agencies.”
“The agencies are given 90 days to put right their legal status, the ministry said. He added that the new law empowers the minister to form committees to under take drafting of regulations and procedures on how the registration is carried out.” (Al-Sahafa [Khartoum], UN Daily Press Review, August 22, 2005)
Of course the clear threat is that humanitarian organizations that don’t “put right their legal status” will be subject to expulsion, the ultimate goal of the NIF in responding to the crisis in Darfur.
Changes are currently underway in the national “Humanitarian Affairs Commission” (HAC), and it is unclear whether these new regulations will have the full destructive impact that is clearly potential. Moreover, a recent ministerial decree from HAC continues the supposed “fast-tracking” of humanitarian access for three months (i.e., continues only the present methods of obstructing humanitarian relief). But the new regulations received strong editorial endorsement from the “Sudan Vision” newspaper, the “news” outlet that most directly reflects NIF opinion, indeed is essentially a NIF propaganda organ:
“Though it has come late, the decision to review the presence of foreigners in Sudan was a fortunate one. In every sovereign state immigration into the country is subjected to tight rules necessitated by security considerations.” [ ]
“Under the circumstances, Sudan government should impose tight control on the entry of all individuals to ensure that its security will not be affected by parties that could enter under the disguise of missions other than their real intentions.” (“Editorial: Review of entry and exit permits,” Sudan Vision newspaper, from the UN Daily Press Review, August 22, 2005)
There can be little doubt that the NIF, again prior to the official formation of the GNU, has put in place a potentially devastating bureaucratic tool for the obstruction and harassment of humanitarian organizations. Any assessment of human mortality in Darfur going forward must take full account of the ability of the NIF to obstruct the humanitarian assistance upon which so many hundreds of thousands of lives are now critically dependent.
THE ABUJA PEACE PROCESS
There is little promise of diplomatic relief coming from either international pressure upon the NIF or negotiations in Abjua, Nigeria. Though the African Union has announced that the NIF and the two insurgency movements are scheduled to resume talks on September 15, 2005 (delayed from August 24, following a previously inconclusive session in early July), there is little evidence that the insurgency leaders will provide a united front. And only such a united front, within and between the two insurgency movements, has any chance of pressuring the NIF to engage in serious negotiations.
The continuing split within the SLA/M between President Abdel Wahed Mohamed al-Nur and Secretary-General Minni Arcua Minnawi is particularly ominous, and may portend a full-scale breakdown between the military forces on the ground in Darfur and political elements negotiating in Abuja. Moreover, as Reuters reported at the time of the previous session in late June/early July, “divisions are also rife within the smaller Justice and Equality Movement, represented in Abuja by Khalil Ibrahim”; “Ibrahim’s leadership was rejected in April  by Justice and Equality field commanders” (Reuters, June 28, 2005).
The previous round of talks ended without progress beyond the signing of a vague document purporting to spell out a “declaration of principles.” For those inclined to see hope in this painfully modest achievement, it should be recalled that is was eight years between the time that Khartoum’s NIF regime agreed to a “declaration of principles” for southern Sudan (1997) and the culmination of negotiations in a formal agreement on January 9th of this year. There were no specific agreements in Abuja, only hopelessly general principles such as:
“‘upholding democracy,’ [ ] ‘justice and equality for all, regardless of ethnicity, religion and gender,’ [ ] ‘an effective devolution of powers’ to regional authorities[,] ‘Darfur’s people should be ensured of a role in all levels of government.'” (Associated Press, July 5, 2005)
Fine principles in the abstract, but in Khartoum’s eyes utterly unconstraining as diplomatic terms of reference. All the difficult work has been put off until the upcoming negotiating session. And even the acrimonious July session may have achieved less than suggested by ebullient newswire headlines. A spokesman for the smaller of the two insurgency groups (the Justice and Equality Movement) declared that “his group was disappointed with the document [and] that it had only signed up under pressure from the African Union and the broader international community” (Agence France-Presse [Abuja], July 5, 2005).
Disarray within the rebel movements, along with a lack of diplomatic capacity and experience, ensures that the highly skilled NIF will be able to give the appearance of negotiating seriously without making any substantial concessions. All the while, ongoing death and suffering in Darfur work to consolidate the effects of previous genocidal ambitions.
Moreover, far too little attention has been paid in Abuja to the enormous challenges of reconstruction and compensation in Darfur, should a meaningful peace agreement ever be signed by the NIF. For without the commitment of enormous national and international resources to re-building a land that has been ravaged beyond description, and at least partial compensation provided to the almost 3 million people who have lost everything through displacement and death, there will be no peace in Darfur. The major insurgency movements may disintegrate; but unless meaningfully addressed, the underlying anger, despair, and losses of those who have survived the genocide ensure that violence will powerfully disrupt livelihoods throughout Darfur for many years to come.
Some have persuasively argued that destruction to date constitutes a form of “cultural genocide”: the ways of life, the bonds to the land, the wealth of generations, the agricultural traditions of centuries have been lost, perhaps irretrievably. Traditional relations between Arab and non-Arab peoples in Darfur are perhaps the greatest casualty of the genocide, even as it must be remembered that only some of the Arab tribal groups are implicated in the vast depredations of the Janjaweed and other paramilitary forces. (See yesterday’s “Ideology in arms: The emergence of Darfur’s Janjaweed,” a deeply revealing, fine-grained account by Sudan experts Julie Flint and Alex de Waal—an excerpt from their forthcoming book, “Darfur: A Short History of a Long War,” at http://www.iht.com/getina/files/272287.html; see also de Waal’s superb “Counter-insurgency on the cheap,” London Review of Books, August 2004, at http://www.lrb.co.uk/v26/n15/waal01_.html).
TRAPPED AMIDST GENOCIDAL DESTRUCTION
The human beings who will die in Darfur still have voices, still make the same desperate plea to the international community that they be protected from the reign of terror that the NIF sustains by means of its Janjaweed militia allies. Unchecked despite the UN Security Council “demand” over a year ago that Khartoum disarm these brutal agents of genocide, the Janjaweed remorselessly squeeze life out of Darfur. Even in villages that the NIF claims to have been “secured,” the livelihoods of African Darfuris have given way to prison-like conditions that ensure slow extinction:
“Darfur refugees who returned to a village cited by Khartoum as a model of security say they are virtual prisoners, fearing renewed attack by Arab militias if they venture out. The inhabitants of Sania Delaiba in South Darfur state fled fighting and had their homes burnt last May. They returned home a few months later and were compensated by the Khartoum government, but say they feel trapped in their small village of about 2,000 inhabitants south of the state capital Nyala.”
“‘We didn’t come home just to sit here in our village and do nothing—we want to go out and farm,’ said Salih Eissa Abakr, a religious leader in the village. ‘We are scared of this area outside the village—there are Arab camel and cattle herders who attack us,’ he said. ‘There’s no woman who goes outside, not even the men want to go out of the village,’ said Halima Abdellahi Ahmed.” (Reuters [dateline: Sania Delaiba (South Darfur)], June 26, 2005)
This is the genocidal status quo in Darfur; unless changed—and the international community shows neither the will nor the desire to effect such change—humanity in Darfur will be relentlessly, remorselessly, unceasingly destroyed. The African tribal peoples of Darfur—the Fur, the Masseleit, the Zaghawa, the Tunjur, the Dajo, the Birgid, and others—will continue to die because of who they are, “as such” in the key phrase from the 1948 Genocide Convention. Their deaths will be represented, minimally, in the mortality totals that continue to grow, month in and month out, however imprecisely reckoned.
To every number, to every single number, we must at least conceptually assign a face, a story, a family, and understand the hole that has been rent in many lives—finally in our lives, at least our moral lives. The particular story of Fatima Ibrahim (rendered here by George Wolf of Refugees International in the Washington Post of July 31, 2004) has no special statistical significance, as is only appropriate if it is to serve its purpose here. I cite her story because it represents a cruelty and evil I neither understand nor dare cease to confront. It represents with terrifying clarity the genocidal animus in Darfur:
“On the morning of July 12,  hell descended on the village of Donki Dereisa. Shortly before sunrise, Fatima Ibrahim, 28, awoke to the deafening sound of exploding ordnance falling from the sky. As she emerged from her mud hut with her 10-year-old daughter, she saw fires blazing all around and scores of heavily armed men on horseback attacking from every direction. With bullets whistling past, Ibrahim and her daughter ran for their lives, ducking into a nearby ravine, where they hid without food or water for the next two days.”
“From the ditch, Ibrahim witnessed a horrific avalanche of violence that will haunt her for life. With Sudanese foot soldiers at their side, the mounted attackers shot the panicked and unarmed villagers in cold blood. Approximately 150 people, including 10 women, were killed. But the worst was to come.”
“Ibrahim told Refugees International about a week after the attack that among those captured during the assault were four of her brothers and six young children, including three of her cousins. As Ibrahim watched in horror, several of the attackers began grabbing the screaming children and throwing them one by one into a raging fire. One of the male villagers ran from his hiding place to plead for their lives. It was a fatal error. The raiders subdued the man and later beheaded him and dismembered his body. All six of the children were burned. Ibrahim’s four brothers have not been heard from since.” (Washington Post, July 31, 2004)
This is the hatred that has been loosed in Darfur; this is the violence that terrifies the more than two and a half million people who have been uprooted from their homes in Darfur, and who are far too fearful to return. These are the people who, having endured the worst of genocidal violence, now confront the ongoing threat of death amidst a grim genocide by attrition. These are the people who add to the relentlessly growing total of dead.
These are the people we have abandoned to the tenuous reach of humanitarian workers, themselves more, not less, vulnerable to the genocidal ambitions of Khartoum’s National Islamic Front. These are the victims we have chosen to leave powerless before the forces of evil and destruction, which will not cease to act without international intervention.
This is the true meaning of “never again.”
Northampton, MA 01063
APPENDIX 1: Current total mortality in Darfur
What is the current monthly mortality rate in Darfur? How many people are at risk of genocidal destruction? How many have died?
An absence of new mortality data, from either the UN or nongovernmental organizations, obliges continuing use of data that does not reflect present realities on the ground. For specifically violent mortality, we have not had meaningful new data for almost a year: monthly AU “estimates” for Darfur as a whole are worthlessly anecdotal. This obliges, most significantly, continuing reliance upon the UN World Health Organization (WHO) survey of mortality rates, essentially from disease and malnutrition, during the period December 2004 to May 2005—arguably the period in which mortality rates have been at their lowest since early in the conflict.
Part A: The total number of conflict-affected persons in Darfur
But even the WHO-overseen survey, which specifies no relevant denominator (the total population for whom the mortality rates are relevant), suggests intolerable levels of human destruction. This is especially true given the enormous rise in the conflict-affected population for Darfur. The UN’s Darfur Humanitarian Profile No. 14 ([DHP 14], representing data as of May 1, 2005) indicated that 2.73 million persons were conflict-affected. By contrast, the most recent Darfur Humanitarian Profile (No. 16 [DHP 16], representing data as of July 1, 2005) indicates a conflict-affected population in Darfur “over 3.2 million” (page 3). This figure does not include the roughly 200,000 refugees in eastern Chad. (All the Darfur Humanitarian Profiles are available at: http://www.humanitarianinfo.org/darfur/infocentre/HumanitarianProfile/index.asp)
In other words, half a million people were added to the category of “conflict-affected” between May 1, 2005 and July 1, 2005.
Since even this staggering figure of “over 3.2 million” is itself two months old, and since Chart 1 of DHP 16 (page 3) graphs a sharp, straight-line increase in the “total affected population,” the number of conflicted-affected persons now certainly exceeds 3.5 million; this is the estimated number of people that the UN’s World Food Program has for months been predicting would be in need of food assistance from August through October, at least. Indeed, the total conflict-affected population within Darfur, including inaccessible rural areas, is likely closer to the estimate of 4 million cited by Jan Egeland, UN Under-secretary for Humanitarian Affairs, in a February 2005 assessment of the food crisis (UN News Center [New York], February 18, 2005).
The fate of these millions of people depends increasingly upon humanitarian relief. And yet despite extraordinary efforts by the UN World Food Program (WFP) and the International Committee of the Red Cross, the shortfall in assistance only grows: in July, even as the WFP targeted a greater number of people for food deliveries, more than 100,000 fewer people actually received food aid than in June. The August figure will surely show a much greater gap between those targeted for aid and actual deliveries. This, too, is part of Khartoum’s genocidal calculus.
Part B: Mortality rate estimate by the UN World Health Organization (WHO)
For the period of November 2004 to May 2005, the WHO-overseen mortality assessment in Darfur indicated a Crude Mortality Rate (CMR) of 0.8 (the CMR measures the number of deaths per day per 10,000 of affected population). Given the various and significant limitations in the reach of the survey, particularly in South Darfur (twice as large as the other two Darfur states and currently site of most ongoing destruction), this writer has argued that a more appropriate CMR is 0.9 (see also various other factors cited in the June 30, 2005 mortality assessment as likely to produce a misleadingly low CMR in the WHO-overseen study; at http://www.sudanreeves.org/modules.php?op=modload&name=Sections&file=index&req=viewarticle&artid=515&page=1). The “normal” CMR for Darfur, according to UNICEF, is 0.3; thus a current CMR of 0.9 indicates an “excess” mortality of 0.6 per day per 10,000 of affected population.
If we assume, now conservatively, 3.5 million conflict-affected persons in Darfur, then there are 6,300 “excess” deaths per month—over 200 human beings dying every day from the consequences of ethnically-targeted warfare and deliberate restrictions on humanitarian access. (The figure rises to 7,200 “excess” deaths per month if we assume 4 million conflict-affected persons.)
Thus in the two months since the last assessment by this writer, which found that approximately 360,000 people had died in the genocide (again, see “Darfur Mortality Update,” June 30, 2005; URL above), almost 15,000 more people have died, bringing the estimated total to over 370,000. Because the CMR has likely increased significantly since the period of the WHO-overseen mortality study (November 2004 to May 2005), particularly with the start of the heavy rains, calculation of this increase is subject to substantial upward revision with the availability of new data.